Individual provider Active NPI

Beverly A Costinew, PH.D. L.P.

  • Psychologist
  • Farmington Hills, MI
National Provider Identifier
1851408777
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301003869 Issued in MI
Practice address
31700 W 13 Mile Rd
Suite 201
Farmington Hills, MI 48334-2166
Phone
(810) 923-8402
Fax
(810) 355-1337
NPI assigned
Aug 24, 2006
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301003869 MI Primary

Addresses

Primary practice location

31700 W 13 Mile Rd
Suite 201
Farmington Hills, MI 48334-2166

Mailing address

31700 W 13 Mile Rd
Suite 201
Farmington Hills, MI 48334-2166
Phone (810) 923-8402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000191 MI Practitioner - Clinical Psychologist 7113947508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

141 N Milford Rd
Suite 103
Highland, MI 48357-4501
Phone (810) 923-8402

8551 Far Ravine Dr
Pinckney, MI 48169-8600
Phone (810) 923-8402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301003869MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alex E. Costinew PH.D.,P.C. Psychologist Current Accepting new patients
Beverly a. Costinew PHD P.C. Psychologist CurrentSince Dec 1, 2005 Accepting new patients
Voyage Counseling Center P.C. PastSince Mar 1, 2006 Accepting new patients

Locations

31700 W 13 Mile Rd
Ste 201
Farmington Hills, MI 48334
Phone (810) 588-9204

38345 W 10 Mile Rd
Ste 150B
Farmington Hills, MI 48335
Phone (248) 478-0466

141 N Milford Rd
Ste 103
Highland, MI 48357
Phone (248) 937-8682

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1851408777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 W 13 MILE RD",
            "address_2": "SUITE 201",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342166",
            "telephone_number": "810-923-8402",
            "fax_number": "810-355-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 W 13 MILE RD",
            "address_2": "SUITE 201",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342166",
            "telephone_number": "810-923-8402",
            "fax_number": "810-355-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTINEW",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D. L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.